| NPI | 1063802320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB12446400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 288517) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2025-11-11 |