| NPI | 1912260290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD460982) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 252414) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-21 |