NPI | 1689805418 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA0885200) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0009779) |
207Q00000X Family Medicine (Licence: TX S1966) | |
207Q00000X Family Medicine (Licence: FL TPME2484) | |
Enumeration Date | 2009-07-28 |
Last Update Date | 2021-10-21 |