| NPI | 1548694862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09878300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 290794) |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2024-12-30 |