| NPI | 1679062350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020352) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018228) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2021-09-09 |