| NPI | 1508951112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 58345) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA 07023000) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2019-02-18 |