| NPI | 1750735924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020183) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H87900) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2025-08-13 |