| NPI | 1497383467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 321916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 1015289) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2023-10-04 |