| NPI | 1972579944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2019-02347) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 52938) |
| 207Q00000X Family Medicine (Licence: PA MD044331E) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2022-07-21 |