| NPI | 1235271040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD048444L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101054986) |
| 207Q00000X Family Medicine (Licence: NJ 25MA05551200) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2021-03-05 |