| NPI | 1164697041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD443765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08972500) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2016-03-01 |