| NPI | 1578541926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 58249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 204419) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-08-29 |