| NPI | 1821380940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09364500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 260926) |
| Enumeration Date | 2011-05-08 |
| Last Update Date | 2013-09-06 |