| NPI | 1386082147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD458510) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2017-00865) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2023-02-21 |