| NPI | 1487849600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS11429) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 222518-1) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2025-11-13 |