| NPI | 1730339995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0067967) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08475100) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2013-11-07 |