| NPI | 1043730229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 33102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT214371) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-02-07 |