NPI | 1700414091 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: NJ 25MA12412700) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 76460-20) |
Enumeration Date | 2020-03-31 |
Last Update Date | 2025-02-11 |