| NPI | 1841275203 |
|---|---|
| Former Name | TRICIA BEATTY SLATTERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NJ 25 MB08780800) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA OS014981) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2020-09-01 |