| NPI | 1215589056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MA060729) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: PA MA060729) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-11-19 |