| NPI | 1538468129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD488056C) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME172786) |
| 207Q00000X Family Medicine (Licence: VA 0101284206) | |
| 207Q00000X Family Medicine (Licence: MN 78730) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2026-03-11 |