| NPI | 1548305949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 041128) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 282748) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2025-03-14 |