| NPI | 1033840491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 95736) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT227075) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2025-11-19 |