| NPI | 1063683779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME156072) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301097333) |
| 207Q00000X Family Medicine (Licence: NJ 25MA08817800) | |
| 207Q00000X Family Medicine (Licence: NY 260327) | |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2024-04-08 |