| NPI | 1992297337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018513) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2021-10-05 |