| NPI | 1134865447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OTO21476) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT021476) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2022-05-10 |