| NPI | 1073802252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD451489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0011021) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2025-11-25 |