| NPI | 1912908187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 202625) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25M06801400) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-03-13 |