NPI | 1700221223 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10159000) |
Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA1015900) |
320700000X Residential Treatment Facility, Physical Disabilities (Licence: NJ 25MA1015900) | |
Enumeration Date | 2013-05-10 |
Last Update Date | 2024-04-30 |