| NPI | 1366565509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD 153491) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD433101) |
| 207Q00000X Family Medicine (Licence: WA MD.MD.61420145) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2023-04-04 |