| NPI | 1053610626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08655100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 259316) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2012-03-04 |