| NPI | 1003992579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD032043E) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: PA MD032043E) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-12-11 |