| NPI | 1407236623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 38242) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD464526) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2021-11-02 |