| NPI | 1629062419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA06248800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA06248800) |
| 208D00000X General Practice (Licence: NJ 25MA06248800) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2009-01-29 |