| NPI | 1245322635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102201796) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 217-681) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2024-08-21 |