| NPI | 1124647391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD68560) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT220523) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-08-01 |