| NPI | 1972033843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA11273900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 306249) |
| 207V00000X Obstetrics & Gynecology (Licence: NY 306249) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: NJ 25MA11273900) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-08-09 |