| NPI | 1134340151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301088972) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 297340) |
| 207Q00000X Family Medicine (Licence: CT 052170) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2025-01-31 |