| NPI | 1770802399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 275980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 76241) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2024-01-07 |