| NPI | 1568456846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 3539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA04869600) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2014-12-16 |