| NPI | 1457349441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA05458800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101248340) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2013-02-19 |