NPI | 1831419399 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09152900) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 25MA09152900) |
207QA0000X Family Medicine, Adolescent Medicine (Licence: NJ 25MA09152900) | |
Enumeration Date | 2010-06-08 |
Last Update Date | 2014-06-27 |