| NPI | 1053301499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA68294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD071288L) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-02-21 |