| NPI | 1518015783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MB55121) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: NJ 25MB05512100) |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2019-10-17 |