| NPI | 1942389242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A65095) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 225566) |
| 207Q00000X Family Medicine (Licence: NJ MA074799) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2021-12-03 |