| NPI | 1972865772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09465600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 260528) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2017-04-26 |