| NPI | 1215911987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB08313300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS005360L) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2017-03-20 |