| NPI | 1770699613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 295643) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101239733) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-08-19 |