| NPI | 1316584923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MT237845) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R80894) |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2026-07-02 |