| NPI | 1649682907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017811) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015740) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2021-04-21 |