NPI | 1629240668 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 270295) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08807400) |
Enumeration Date | 2008-03-31 |
Last Update Date | 2020-11-25 |