| NPI | 1740263706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 35559) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA07901000) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2014-01-03 |