| NPI | 1063670156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 255554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT192886) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2014-03-07 |