| NPI | 1710074273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 201502211) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS014425) |
| 207Q00000X Family Medicine (Licence: PA OT011566) | |
| 207Q00000X Family Medicine (Licence: WV 2688) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2023-08-07 |