| NPI | 1720375439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 298584) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA08900100) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2019-09-12 |