NPI | 1518608884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 337766) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 390200000X) |
Enumeration Date | 2022-04-02 |
Last Update Date | 2025-07-29 |