| NPI | 1679740674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 6458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT 190710) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2021-05-27 |