| NPI | 1649915687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 340671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD491705) |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2025-12-09 |