| NPI | 1134616576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD484914) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD484914) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: FL ME157872) | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2025-04-09 |