| NPI | 1750652608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09159900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 266733) |
| 207Q00000X Family Medicine (Licence: TX P9505) | |
| Enumeration Date | 2012-01-24 |
| Last Update Date | 2015-07-13 |