| NPI | 1699406652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0103765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT227172) |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-09-08 |