| NPI | 1396158606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H83105) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015909) |
| 207Q00000X Family Medicine (Licence: DC D0034658) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-06-06 |