| NPI | 1932109162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 52148) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 211539) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-02-15 |