| NPI | 1639462419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD451765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D85437) |
| 207Q00000X Family Medicine (Licence: NY 294120) | |
| 207Q00000X Family Medicine (Licence: MI 4301115462) | |
| 207Q00000X Family Medicine (Licence: MA 275516) | |
| 207Q00000X Family Medicine (Licence: FL ME136342) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2023-12-20 |