| NPI | 1407058043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY F350658-01) |
| Additional Taxonomies | 374T00000X Religious Nonmedical Nursing Personnel (Licence: NY 477645-1) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2024-09-17 |