| NPI | 1861679904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08407900) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08407900) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2020-02-20 |