| NPI | 1679912430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017334) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-10029) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2024-01-17 |