| NPI | 1083272587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 92249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT217966) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2022-07-21 |