| NPI | 1588955165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10656700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 275193) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2022-03-30 |