| NPI | 1437561842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H0090975) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 293243) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2022-05-26 |