| NPI | 1659637635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 275094-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 275094) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2023-07-06 |