| NPI | 1164646253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25IB12158000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 077185) |
| 207Q00000X Family Medicine (Licence: MN 49311) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2025-08-04 |