| NPI | 1023645355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 337495) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A188469) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-08-05 |