| NPI | 1013323450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R7043) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA10059700) |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-05-28 |