| NPI | 1699764373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA07192900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A79223) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2020-10-16 |