| NPI | 1497487631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD29342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT225947) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2025-07-01 |