| NPI | 1598010571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10646800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1107) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-01-11 |