| NPI | 1265711576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB09343300) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT014041) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2016-04-08 |