| NPI | 1588907265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 265845) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 232111-1) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2016-09-19 |