| NPI | 1699742387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD064476L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 220136) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2021-03-18 |