| NPI | 1861620791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09631500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 270402) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2022-12-02 |