| NPI | 1972952471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-21662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT211813) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2023-11-03 |