| NPI | 1437350923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15890) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 249155) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-06-10 |