| NPI | 1306257001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD456019) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD456019) |
| 208D00000X General Practice (Licence: PA MD456019) | |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2025-01-30 |