| NPI | 1932302155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 242461-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08220700) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2013-07-31 |