| NPI | 1417688268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT022143) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OT022143) |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2025-01-02 |