| NPI | 1326721416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 030292) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 030292) |
| 363A00000X Physician Assistant (Licence: NY 030292) | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-09-28 |