| NPI | 1427050939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 82694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 244387) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NY 233892) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2025-10-08 |