| NPI | 1124013206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 15019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD438281) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2021-10-18 |