| NPI | 1578874913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS021947) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS13913) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-10-04 |