| NPI | 1699138552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10614900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R4100) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2019-07-17 |