| NPI | 1730347030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 251998-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME125729) |
| 207Q00000X Family Medicine (Licence: CA A113319) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2022-02-14 |