| NPI | 1982679353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 225239) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 49182) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2018-04-24 |