| NPI | 1790710333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08032600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200300079) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |