| NPI | 1659735769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 297908) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 267280) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2019-09-10 |