| NPI | 1700133477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD050727L) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA MD050727L) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2026-06-18 |