| NPI | 1205098530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 272992) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 261373) |
| 207Q00000X Family Medicine (Licence: NJ 25MB11207800) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2023-09-29 |