| NPI | 1962436006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.10910R) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD-450510) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-12-31 |