NPI | 1619135530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD443388) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09098700) |
207Q00000X Family Medicine (Licence: NY 313603) | |
Enumeration Date | 2008-05-28 |
Last Update Date | 2024-06-20 |