| NPI | 1073193306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301518265) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD482528) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2026-06-15 |