| NPI | 1629070644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS008842L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 2703) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2024-10-28 |