NPI | 1417335498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10877500) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.132627) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2023-09-18 |