| NPI | 1154642486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NJ 25MA08999800) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CT 051503) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2021-12-08 |