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 |