| NPI | 1124258314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 50467) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT192821) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2024-02-01 |