| NPI | 1720345606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 268251) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MA 268251) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NY 302979) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-08-02 |