| NPI | 1093127946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 295752) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 295752) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 76146) | |
| 207Q00000X Family Medicine (Licence: CT 76146) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: CT 76146) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2026-03-26 |