| NPI | 1912165010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A117448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD443164) |
| 207Q00000X Family Medicine (Licence: NY 261843) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2021-11-29 |