| NPI | 1639300247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME154313) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09010200) |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2022-09-21 |