| NPI | 1376884254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI AMD-1109) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MA055956) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00302900) | |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2022-07-20 |