| NPI | 1093921496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00047885) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT183432) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-04-07 |