| NPI | 1558896969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2020022479) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 296672) |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2023-06-30 |