| NPI | 1396182648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301111201) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD459896) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2021-10-07 |