| 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 |