| NPI | 1114612264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD497111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 114535) |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2026-09-02 |