| 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 | 2020-10-19 |