| NPI | 1891056164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09409100) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2023-10-26 |