| NPI | 1679100283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD487358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A183039) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-06-10 |