| NPI | 1952784274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 79638) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 296959) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2025-02-07 |