| NPI | 1417278805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08769600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 2569671) |
| Enumeration Date | 2010-06-19 |
| Last Update Date | 2018-12-07 |