| NPI | 1467183699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 329449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 1023912) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2025-09-08 |