| NPI | 1356704670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL me154881) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 299521) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2022-03-10 |