| NPI | 1477640837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: NJ 25MB06988300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB06988300) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2011-06-01 |