| NPI | 1467959833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2023-00621) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD474116) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2023-11-08 |