| NPI | 1538367263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 243069) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 243069) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 243069) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2025-06-19 |