| NPI | 1760167746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT022441) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS024484) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2026-05-01 |