| NPI | 1225562556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 311014-01) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD048387) |
| 207Q00000X Family Medicine (Licence: MD H0089976) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2021-07-13 |