| NPI | 1609366202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD475168) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT214943) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2021-08-10 |