| NPI | 1912285800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 19049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS016540) |
| 207V00000X Obstetrics & Gynecology (Licence: PA OS016540) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2019-12-12 |