NPI | 1740859016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB12380700) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS023958) |
Enumeration Date | 2021-06-22 |
Last Update Date | 2024-09-16 |