| NPI | 1992133789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017893) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015547) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2019-01-31 |