| NPI | 1831750009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME155242) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT217870) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-07-07 |