| NPI | 1609212190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-00989) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266634) |
| Enumeration Date | 2013-05-11 |
| Last Update Date | 2021-11-11 |