| NPI | 1346873270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 105726) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP020831) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2023-11-01 |