| NPI | 1255587218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CT 53010) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 268162) |
| 207Q00000X Family Medicine (Licence: NJ 25MA09289800) | |
| 207Q00000X Family Medicine (Licence: CT 53010) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2019-01-31 |