| NPI | 1972916526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10296100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 288243-1) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2021-10-22 |