| NPI | 1760458426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB09870900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 233670) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2019-03-05 |