| NPI | 1477793735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD444870) |
| Additional Taxonomies | 174400000X Specialist |
| 207Q00000X Family Medicine (Licence: VA 0101244874) | |
| 207Q00000X Family Medicine (Licence: OH 57011276) | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2023-03-20 |