| NPI | 1730340167 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA08638200)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE CI-0009221)  | 
| 207Q00000X Family Medicine (Licence: PA MD438129)  | |
| Enumeration Date | 2008-06-18 | 
| Last Update Date | 2025-05-28 |