| NPI | 1497322721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101280256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT223527) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-09-27 |