| NPI | 1538654413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 312443) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 312443) |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2026-07-24 |