| NPI | 1306475694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 326307) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA13258500) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2026-08-03 |