| NPI | 1578718110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16468) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 262392) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2024-08-20 |