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 |