| NPI | 1346863198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 076003) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT019944) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-09-09 |