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 |