| NPI | 1275192528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS022152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA FP1591925) |
| 207Q00000X Family Medicine (Licence: PA OT019161) | |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2022-08-11 |