| NPI | 1548374747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA72031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 218273) |
| 207Q00000X Family Medicine (Licence: FL ME108236) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-07-30 |