| NPI | 1093980419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101249334) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT192271) |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2017-04-10 |