| NPI | 1376115741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: PA OA005669) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MA062565) |
| 207Q00000X Family Medicine (Licence: PA OA005669) | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2024-09-23 |