| NPI | 1497073274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NY 272804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA10073600) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NJ 25MA10073600) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2024-02-05 |