| NPI | 1902042286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB09143600) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA 0T012760) |
| 207Q00000X Family Medicine (Licence: NY 282442) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2019-07-24 |