| NPI | 1396367074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME164098) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT220837) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2024-01-12 |