| NPI | 1558650663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 60273594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 273594) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2023-07-06 |