| NPI | 1609271493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB10154000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA 016128) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2019-07-08 |