| NPI | 1306294699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 304587) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 272139) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2020-07-02 |