| NPI | 1558542332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 54760-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT191769) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2023-05-09 |