| NPI | 1447243696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD008721E) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA07177100) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2007-07-08 |