| NPI | 1437561347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 85986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 04188) |
| 207Q00000X Family Medicine (Licence: NY 278813) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2025-10-07 |