| NPI | 1508267485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 290258) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 1811968993) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2020-09-23 |