| NPI | 1639284003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 259001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A91346) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2026-07-22 |