| NPI | 1811562705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS023666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT020794) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2024-05-10 |