| NPI | 1700174166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 25MB09370100) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A 11319) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116023928) | |
| 207Q00000X Family Medicine (Licence: RI DO01078) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2026-07-16 |