| NPI | 1306033014 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD445031)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT193275)  | 
| 207V00000X Obstetrics & Gynecology (Licence: MI 4301091142)  | |
| Enumeration Date | 2007-09-26 | 
| Last Update Date | 2023-03-30 |