| NPI | 1003991118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA12589900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 217162) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2025-04-30 |