| NPI | 1639794530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB11826400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT020041) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2023-11-29 |