| NPI | 1699111773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD467505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME127341) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2025-08-15 |