| NPI | 1821447871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-03392) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 299038-01) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2022-05-23 |