| NPI | 1225488620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 91090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS018950) |
| 207Q00000X Family Medicine (Licence: NC 2021-02165) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2024-04-30 |