| NPI | 1801044847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N0868) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08387800) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2016-05-11 |