| NPI | 1932204948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 55943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 188871) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-06-18 |