NPI | 1679516850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD427968) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A69904) |
207Q00000X Family Medicine (Licence: NJ 25MA10208700) | |
Enumeration Date | 2006-06-14 |
Last Update Date | 2024-10-28 |