| NPI | 1992116552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD462502) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT206817) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2020-02-28 |