| NPI | 1649700477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 312281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 272209) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-09-24 |