| NPI | 1609014133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-02934) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 258078) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2020-10-05 |