| NPI | 1740269018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS007580L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB05811600) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2015-09-30 |