| NPI | 1619127024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB09074300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 262304) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2016-09-02 |