| NPI | 1164676342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 286464) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D95826) |
| 207Q00000X Family Medicine (Licence: IL 036141790) | |
| 207Q00000X Family Medicine (Licence: CA 145168) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA08504500) | |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2025-03-14 |