| NPI | 1265093439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 65815) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT217296) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-07-27 |