| NPI | 1649455841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A115524) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD438833) |
| 207Q00000X Family Medicine (Licence: NY 265201-1) | |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2022-07-21 |