| NPI | 1285778571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q7160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA07818000) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2025-11-18 |