| NPI | 1124408471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS018853) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016721) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2023-05-15 |