| NPI | 1235498064 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10132200)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 272986)  | 
| Enumeration Date | 2012-05-14 | 
| Last Update Date | 2024-11-12 |