| NPI | 1912292103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD490813C) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60224901) |
| 207Q00000X Family Medicine (Licence: NJ 25IA12682400) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2025-08-01 |