| NPI | 1134780448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB11503500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT019572) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2025-06-17 |