| NPI | 1104496918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD490700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 35983) |
| 208600000X Surgery (Licence: PA MT224095) | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2025-09-22 |