| NPI | 1942404751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P0074) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB08503200) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-05-06 |