| 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 |