| NPI | 1922732999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 032368) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MP00867100) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-09-20 |