| NPI | 1861997983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 289069) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 30286501) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2026-04-30 |