| NPI | 1811900608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 338725) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA05621900) |
| 207Q00000X Family Medicine (Licence: FL ME148626) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-12-28 |