| NPI | 1922080811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200501955) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB6325500) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2018-08-06 |