NPI | 1306294699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 304587) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 272139) |
Enumeration Date | 2016-05-27 |
Last Update Date | 2020-07-02 |