| NPI | 1619268471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-02348) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS017108) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2023-12-05 |