| NPI | 1578959458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 291422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 73147) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2025-04-29 |