| NPI | 1316371347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA MD488788) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY P14559) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2025-10-03 |