| NPI | 1205455177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA12150700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD486533) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-01-15 |