| NPI | 1760914113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ P19-01027) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2021-12-02 |