| NPI | 1871760033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 259018) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 625) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2017-07-05 |