| NPI | 1629206693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD447191) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 270783) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: PA MD447191) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2020-08-12 |