| NPI | 1083609846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA05590000) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NJ 25MA05590000) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2009-07-28 |