| NPI | 1487901781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME160353) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R2166) |
| 207Q00000X Family Medicine (Licence: PA MT202828) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2023-09-26 |