| NPI | 1144663352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10631700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q9659) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2022-07-27 |