| NPI | 1689336794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 26NJ01214800) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 26NR21452700) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-12-13 |