| NPI | 1275553315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 202102093) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 209897) |
| 207Q00000X Family Medicine (Licence: NY 255583) | |
| 207Q00000X Family Medicine (Licence: PA MD072672L) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA08161500) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-08-09 |