| NPI | 1831255447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 1193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25mb07373900) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-05-11 |