| NPI | 1710360599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD470236) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 278077) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-11-28 |