| NPI | 1386218501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS023698) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT020612) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2024-08-07 |