| NPI | 1487633533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 43958) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA04062800) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2015-11-25 |