| NPI | 1265920300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 305668) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 305668) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-07-07 |