| NPI | 1326221771 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N1823) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08265000) | 
| Enumeration Date | 2007-12-07 | 
| Last Update Date | 2017-01-25 |