| NPI | 1134416191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25IB12198100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34.013071) |
| 207Q00000X Family Medicine (Licence: WI 2842) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-09-11 |