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 |