| NPI | 1699765354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MB07867200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0007502) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2008-10-06 |