NPI | 1700107554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 270094) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 290260) |
207Q00000X Family Medicine (Licence: NC 2021-02681) | |
207Q00000X Family Medicine (Licence: TX V3100) | |
Enumeration Date | 2010-06-16 |
Last Update Date | 2025-04-11 |