| NPI | 1881004588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10120300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 289683) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2020-03-18 |