| NPI | 1639581960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102204999) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2020-11-12 |