| NPI | 1083241004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 323001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB13165000) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-06-29 |