| NPI | 1285891796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60851634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08802800) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2020-08-20 |