| NPI | 1811244064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 275521) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB09565700) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2016-09-20 |