| NPI | 1720061476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243642) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD067375L) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2023-01-27 |