| NPI | 1417363441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10110200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 289873) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2022-10-24 |