| NPI | 1821319443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301116555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT197208) |
| 207Q00000X Family Medicine (Licence: PA MD449325) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-01-19 |