| NPI | 1003477407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS022402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT019591) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2022-08-26 |