| NPI | 1851730683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 289587) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 256378) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-01-27 |