| NPI | 1780912485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS14982) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A13304) |
| 207Q00000X Family Medicine (Licence: NJ 25MB08676500) | |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2019-10-02 |