| NPI | 1598326795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD478644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT219011) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2025-07-08 |