Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 005938 | CT |
NPI | 1053714170 |
---|---|
Provider Name | Muneera Panjwani |
First Address | Middlebury, CT 06762-1835 |
Second Address | Middlebury, CT 06762-1835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 13/02/2020 |