| NPI | 1710057625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ MA55483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA05548300) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-26 |