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 |