| NPI | 1366843138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD458577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09987900) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2021-01-06 |