| NPI | 1760482657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0090776) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD064156L) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2022-05-16 |