| NPI | 1043831563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MT220180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U2366) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-09-25 |