| NPI | 1780178673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD474536) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA mt215655) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2025-10-28 |