| NPI | 1811008436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200801532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MA06114800) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-09-09 |