| NPI | 1639584972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 288066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT206964) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2018-03-17 |