| NPI | 1003046889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 61178) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT196080) |
| 207Q00000X Family Medicine (Licence: NJ 25MA09156100) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2021-02-15 |