| NPI | 1922501568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10172400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 294586) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2021-03-10 |