| NPI | 1881628436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WV 30878) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ MA07823800) |
| 208D00000X General Practice (Licence: PA MD427933) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-10-03 |