| NPI | 1407204571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10614800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS019233) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-03-12 |