| NPI | 1902957905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD440939) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 226201) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2025-10-17 |