| NPI | 1962768945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 17817) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 277009) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-07-21 |