| NPI | 1497490288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD490666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2024-01089) |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2025-08-26 |