| NPI | 1497012025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D86664) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 278254) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2022-10-11 |