| NPI | 1972682938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA07685900) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NJ 25MA07685900) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2011-08-30 |