| NPI | 1942553995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD455544) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202911) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2023-05-08 |