| NPI | 1629050281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 57109) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 185132) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2021-10-21 |