| NPI | 1912959099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS013413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25mb07811900) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-01-20 |