| NPI | 1558092593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 333588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT225727) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-01-28 |