| NPI | 1710120407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10111600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10111600) |
| Enumeration Date | 2009-04-11 |
| Last Update Date | 2018-03-17 |