| NPI | 1467772962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 272081) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 325488) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2024-12-12 |