| NPI | 1003837964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 11449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD429395) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2019-01-07 |