| NPI | 1609295765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 80429) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS018894) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-12-10 |