| NPI | 1255460275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB09954200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2008-01417) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2017-01-18 |