| NPI | 1043375918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 27765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09895500) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2023-08-09 |