| NPI | 1497036560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C160848) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME156897) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA09525900) | |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2026-08-25 |