| NPI | 1417119728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10511300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 69997) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2025-11-06 |