| NPI | 1740620822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 287356) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 287356) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 287356) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2022-07-15 |