| NPI | 1376988279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA11105100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD456215) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2025-09-18 |