| NPI | 1285046508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 301769) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0085762) |
| 207Q00000X Family Medicine (Licence: PA MD462538) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2019-12-20 |