| NPI | 1376293258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 86584) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 328517) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2026-10-15 |