| NPI | 1730747841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 79107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 325881) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2024-10-31 |