| NPI | 1629381652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME109273) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08792800) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2022-10-17 |