| NPI | 1245368554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA07379000) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY MA07379000) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2017-12-15 |