| NPI | 1972753408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT192438) |
| Enumeration Date | 2008-09-20 |
| Last Update Date | 2021-04-26 |