| NPI | 1457493694 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 264188) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 264188) | 
| 208D00000X General Practice (Licence: NJ 25MB10756500) | |
| 208D00000X General Practice (Licence: FL 16878) | |
| 208D00000X General Practice (Licence: CA 18641) | |
| 208D00000X General Practice (Licence: CT 69033) | |
| 208D00000X General Practice (Licence: WA OP61157856) | |
| 208D00000X General Practice (Licence: NC 201-02564) | |
| 208D00000X General Practice (Licence: TX T7780) | |
| 208D00000X General Practice (Licence: VA 0102208149) | |
| 208D00000X General Practice (Licence: MO 2023039824) | |
| 208D00000X General Practice (Licence: MA 1016516) | |
| Enumeration Date | 2007-02-13 | 
| Last Update Date | 2025-06-28 |