| 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 |