| NPI | 1083239024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 323392) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB11648900) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2024-01-10 |