| NPI | 1003295817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61075786) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT209044) |
| 207Q00000X Family Medicine (Licence: WA ML60969726) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2021-08-05 |