| NPI | 1679518237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 219865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB07600900) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2008-11-06 |