| NPI | 1659574192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 242461) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 257511-1) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2022-01-25 |