| NPI | 1689802068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 96784) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 282980) |
| 207Q00000X Family Medicine (Licence: MD D0074885) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2023-08-18 |