| NPI | 1619383312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS018598) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016105) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2021-04-14 |