| NPI | 1255527834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ 25mp00135600) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP001356) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2016-05-20 |