| NPI | 1700069234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0071056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT 190649) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2022-02-08 |