| NPI | 1669868592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 278278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 294647) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2019-08-01 |