| NPI | 1720495245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 324832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA10183800) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2025-07-16 |