| NPI | 1245761642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 69016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 303175) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-12-31 |