| NPI | 1770076697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 315583) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 276089) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2023-07-12 |