| NPI | 1063799351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD458008) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: NY 275281) | |
| 207Q00000X Family Medicine (Licence: NJ 25MA09932700) | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2016-09-19 |