| NPI | 1063483774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-01723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB07942900) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2024-01-03 |