| NPI | 1255838819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 341576) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 68737) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2026-02-12 |