| 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 |