| NPI | 1902169832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 300145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0070161) |
| 207Q00000X Family Medicine (Licence: NJ 25MA09890800) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2023-06-27 |