| NPI | 1629459722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD464054) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT208323) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-07-25 |