| NPI | 1366899106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 12624) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT210804) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2025-04-09 |