| NPI | 1679589584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101255031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08132700) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-05-10 |