| NPI | 1245819283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 332959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301512969) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2024-12-02 |