| NPI | 1699417337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 339455) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME172234) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-11-10 |