| NPI | 1760455638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD426105) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA BB9222047) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-01-10 |