| NPI | 1023243292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 265650) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-17800) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2023-08-08 |