| NPI | 1588924997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 076401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT201386) |
| 207Q00000X Family Medicine (Licence: OH 35124324) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2023-03-10 |