| NPI | 1942874797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 330330) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151015093) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-05-28 |