| NPI | 1356784003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA11976500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101258384) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2023-09-20 |