| NPI | 1649332081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD475351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA05211500) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2021-12-01 |