| NPI | 1780668749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB06902200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MB069022) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2024-08-07 |