| NPI | 1275269896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 339193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL18479) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2025-09-08 |