| NPI | 1710565833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MT231972) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MD485057) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2024-12-23 |