| NPI | 1114419645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H091237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018468) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2021-07-14 |