| NPI | 1851884126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 327979) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT216270) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2021-11-02 |