| NPI | 1639137680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15592) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 183249) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2022-12-02 |