| NPI | 1548431307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 249401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08376500) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-09-30 |