| NPI | 1508120932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 294613) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 28681) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2023-11-27 |