| NPI | 1194212266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-48930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA11547900) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2024-03-01 |