| NPI | 1558569814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB08670200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 258781) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2018-03-14 |