| NPI | 1790124394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA09844500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD455944) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2021-04-22 |