| NPI | 1720219926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301102341) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA10206300) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2018-12-05 |