| NPI | 1821639634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY F346954-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD 2019048450) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2023-05-30 |