| NPI | 1871198960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL HSE36437) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TPME1146) |
| 207Q00000X Family Medicine (Licence: NJ NJDCATEMP-037226) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL TPPA672) | |
| 363AM0700X Physician Assistant, Medical (Licence: PR 864-P.A.) | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2024-04-26 |