| NPI | 1588008270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 39090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015173) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2021-06-08 |