| NPI | 1801020425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 68035-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD453333) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2022-02-17 |