NPI | 1902256266 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 306002-01) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A162847) |
Enumeration Date | 2016-06-17 |
Last Update Date | 2023-05-05 |