| NPI | 1801320825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 303024) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 0000000) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2020-06-29 |