| NPI | 1952465130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-00771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD422851) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2022-04-15 |