| NPI | 1780881904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL os13772) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102202721) |
| 207Q00000X Family Medicine (Licence: NJ 25MB08469000) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-12-05 |