| NPI | 1023374667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 64023) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 282049) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2025-08-25 |