| NPI | 1205181617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 17193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202427) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2023-08-21 |