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 |