| NPI | 1659684165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 257977) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD440605) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2026-08-28 |