| NPI | 1073508875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10071800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.128845) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00112400) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2024-10-23 |