| NPI | 1659691236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 270362-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 245240) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2024-08-19 |