| NPI | 1699102848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q8870) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09355900) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2023-02-23 |