| NPI | 1184251308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA12308500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 12177) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2026-08-10 |