| NPI | 1174962773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10106600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015028) |
| 207Q00000X Family Medicine (Licence: PA OS017285) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2021-04-26 |