NPI | 1942664511 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS18998) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB10540800) |
Enumeration Date | 2016-04-11 |
Last Update Date | 2023-06-07 |