| NPI | 1265020069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ NJDCATEMP-037072) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 37767) |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-03-31 |