| NPI | 1003879404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 91697) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 221779-1) |
| 207Q00000X Family Medicine (Licence: NY 221779) | |
| 207Q00000X Family Medicine (Licence: CT 51110) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2022-09-22 |