| NPI | 1972957140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME139448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT210392) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2021-03-29 |