| NPI | 1740357953 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA08529400) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0007638) | 
| Enumeration Date | 2006-11-30 | 
| Last Update Date | 2016-04-25 |