| NPI | 1376569715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD070917L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA06826500) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2023-01-11 |