| NPI | 1467080556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2025-00744) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 323696) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2026-03-05 |