| NPI | 1952046328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS024850) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT021588) |
| Enumeration Date | 2022-05-01 |
| Last Update Date | 2026-05-28 |