| NPI | 1982974739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09587100) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NY 265909) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2018-05-10 |