| NPI | 1629416318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 277415) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 277415) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 277415) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2019-08-01 |