| NPI | 1093128555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO4070) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 611669427) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2026-04-20 |