| NPI | 1891289344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 312856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11020141A) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2021-11-16 |