| NPI | 1043309867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB08335600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS007161-L) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-12-16 |