| NPI | 1215721030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 111111) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 1111111) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 111111) | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |