| NPI | 1255434619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD455161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 279683) |
| 207Q00000X Family Medicine (Licence: PA 455161) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-03-08 |