| NPI | 1902475460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD485695) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT224210) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-01-17 |