| NPI | 1073855185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD458399) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203281) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2024-12-24 |