| NPI | 1548556707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 125051) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 313777) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2026-06-15 |