| NPI | 1922267012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08765300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 239839) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2010-11-08 |