| NPI | 1922440163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 288877) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME128612) |
| 207Q00000X Family Medicine (Licence: MI 4301111547) | |
| 207Q00000X Family Medicine (Licence: MO 2017000133) | |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2020-08-06 |