| NPI | 1720038185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 23351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT186125) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-02-06 |