| NPI | 1528799814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS024711) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT022138) |
| Enumeration Date | 2022-06-18 |
| Last Update Date | 2025-05-14 |