| NPI | 1124554431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD475000) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT212871) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2021-08-10 |