| NPI | 1467483958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 220616) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB07494800) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2014-01-15 |