| NPI | 1063644797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME112049) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT195689) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2022-03-04 |