| NPI | 1164884334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 79980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 303761) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2025-04-18 |