| NPI | 1356861991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2022017851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ TRAINING) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2022-07-11 |