| NPI | 1265538516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 72102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 237529) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2023-03-07 |