| NPI | 1750532503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0009776) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09154200) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2021-09-09 |