| NPI | 1861137457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS024051) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT021960) |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2024-09-17 |