| NPI | 1275991945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME140075) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT210102) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2019-08-26 |