| NPI | 1639464696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NJ 25MA09783500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09783500) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2020-12-14 |