| NPI | 1740597459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 276792) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 14989) |
| 207Q00000X Family Medicine (Licence: NY 269851) | |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2026-04-21 |