| NPI | 1558723353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 300474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA12681400) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-08-12 |