| NPI | 1750348900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB064321) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS009085L) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2015-02-20 |