| NPI | 1891439840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 337890) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD485831) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2025-07-22 |