| NPI | 1104494590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD485063) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT223953) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2024-08-30 |