| NPI | 1902066061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD476056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 201101078) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2022-05-10 |