| NPI | 1265541015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 213266) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06538100) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2015-02-20 |