| NPI | 1447259841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 291980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB073901) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2019-06-18 |