| NPI | 1013404169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 76709) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY P10037) |
| 207Q00000X Family Medicine (Licence: NY 317949) | |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2024-03-30 |