| NPI | 1225425408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 298222) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 79601) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2024-12-09 |