| NPI | 1811559420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 325964) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT019552) |
| 207Q00000X Family Medicine (Licence: PA OS020806) | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2024-11-25 |