| NPI | 1801058417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD442860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT193885) |
| 207Q00000X Family Medicine (Licence: MO 2013012533) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-10-31 |