| NPI | 1164985800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD478362) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA 478362) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2024-12-16 |