| NPI | 1407235112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD464158) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 292527) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2023-05-16 |