| NPI | 1043658081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD19272) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT204605) |
| 207Q00000X Family Medicine (Licence: HI MDR 6673) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2022-12-19 |