| NPI | 1114458544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10728200) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 90872) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-03-07 |