| NPI | 1245203231 |
|---|---|
| Former Name | JEANNIE MODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 042010) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 266293) |
| 207Q00000X Family Medicine (Licence: NY 278792) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2025-03-14 |