| NPI | 1962133538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA12709100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 101010101) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-08-29 |