| NPI | 1538419429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ Training Permit) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2014-12-05 |