| NPI | 1063889541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 277966) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 277966) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2024-11-08 |