| NPI | 1508244260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD190160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT208877) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2019-10-08 |