| NPI | 1598344954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 34229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 78066) |
| 207Q00000X Family Medicine (Licence: NY 334906) | |
| 207Q00000X Family Medicine (Licence: MA 1020156) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2025-11-12 |