| NPI | 1598102394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A135827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 284465-1) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2021-03-10 |