| NPI | 1023547346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 87949) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS020033) |
| 207Q00000X Family Medicine (Licence: NJ 25MB10874700) | |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-07-21 |