| NPI | 1053547919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09219400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA md469728) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2023-10-31 |