| NPI | 1154471969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A93964) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 311843) |
| 207Q00000X Family Medicine (Licence: CT 70319) | |
| 207Q00000X Family Medicine (Licence: PA MD476605) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA067925) | |
| 207Q00000X Family Medicine (Licence: MA 1015522) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2024-06-03 |