| 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 |