NPI | 1184607103 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10460100) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 240377) |
207Q00000X Family Medicine (Licence: FL OS9351) | |
Enumeration Date | 2005-11-23 |
Last Update Date | 2024-10-07 |