| NPI | 1073816708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101249835) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD061499L) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2017-03-13 |