| NPI | 1558327023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301082659) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 222940) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-10-14 |