| NPI | 1386714574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124070) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 231775) |
| 207Q00000X Family Medicine (Licence: NJ 25MA08720000) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-06-22 |