| NPI | 1891182960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 319177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD464217) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2023-03-02 |