| NPI | 1720421209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-00015) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 285053) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2022-01-20 |