| NPI | 1679516850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA10208700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A69904) |
| 207Q00000X Family Medicine (Licence: PA MD427968) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-04-10 |