| NPI | 1578267993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 343567) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 012065) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2026-09-02 |