| NPI | 1598299596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD470893) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 29265) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2021-01-16 |