| NPI | 1649586991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD449797) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: PA MT197700) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2021-05-10 |