| NPI | 1386875698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R0972) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08998500) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2022-07-21 |