| NPI | 1316325129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 327263) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 000) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2024-02-23 |