| NPI | 1124722103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD494132) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0029365) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2026-07-13 |