| NPI | 1538171277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08691900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M0099) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2012-01-18 |