| NPI | 1487821054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB05811700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB58117) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2023-03-31 |