| NPI | 1548483076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 272519) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.090299) |
| 207Q00000X Family Medicine (Licence: CA A72197) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-01-19 |