| NPI | 1588868749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 242719) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08048500) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2024-08-26 |