| NPI | 1902821341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI DOS 1443) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 233069) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-05-12 |