| NPI | 1205118361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U5612) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA10007400) |
| 207Q00000X Family Medicine (Licence: PA 457896) | |
| 207Q00000X Family Medicine (Licence: CT 53081) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2023-08-11 |