| NPI | 1912092875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 45730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 238735) |
| 207Q00000X Family Medicine (Licence: CT 045730) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-02-14 |