| NPI | 1396768578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-01610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 90754) |
| 207Q00000X Family Medicine (Licence: NY 273032) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-05-09 |