| NPI | 1760896500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 282392) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A130797) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2022-07-21 |