| NPI | 1184245615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101277895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT220185) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-05-24 |