| NPI | 1821352295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB11676500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS017193) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2026-06-15 |