| NPI | 1114212552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 073819) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD451019) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2019-10-29 |