| NPI | 1831419399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R0507) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: NJ 25MA09152900) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA09152900) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA09152900) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2025-03-19 |