| NPI | 1710978309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD431137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 98164) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-12-12 |