| NPI | 1073173381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NJ 25MA11715700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT218594) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-10-02 |