| NPI | 1073563250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 38669) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 056715) |
| 207Q00000X Family Medicine (Licence: PA MD447136) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-07-21 |