| NPI | 1619917788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10235700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD072498L) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-04-29 |