| NPI | 1750644803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD453458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT201477) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2022-06-01 |