| NPI | 1629238134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD462782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A113759) |
| 207Q00000X Family Medicine (Licence: PA MT193466) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2022-02-09 |