| NPI | 1518527779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 318492) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116033077) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-08-09 |