| NPI | 1497160626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD D83431) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0083431) |
| 207Q00000X Family Medicine (Licence: PA MT206960) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2023-05-10 |