| NPI | 1639904246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA SP030299) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 26NJ15128500) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-13 |