| NPI | 1245735745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 317612) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA11670100) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-06-26 |