| NPI | 1649678145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO208156) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS020625) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2022-10-13 |