| NPI | 1912451337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 72894) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 301413) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2024-11-04 |