| NPI | 1023304250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 006414) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT014006) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2020-01-06 |