| NPI | 1083121776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-02510) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD471281) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2024-09-26 |