| NPI | 1346773074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 305869) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 285671) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2021-12-01 |