| NPI | 1689014359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD459597) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203649) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2020-06-12 |