| NPI | 1073962205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01858) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB10442300) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2023-03-02 |