| NPI | 1376505057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA08466600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD418025) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2020-10-19 |