| NPI | 1437642931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT018537) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 81552-21) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2024-11-14 |