| NPI | 1427378876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2016-00734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS016533) |
| 207Q00000X Family Medicine (Licence: NJ 25MB09343400) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2016-05-04 |