| NPI | 1093065542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09616800) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA09616800) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2024-04-11 |