| NPI | 1689087280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD461235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT207228) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2019-10-30 |