| NPI | 1033679584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 80179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0098982) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2026-08-20 |