| NPI | 1699119354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 329910) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 265577) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2026-08-28 |