| NPI | 1780144196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 323237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101282768) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-07-24 |