| NPI | 1124091954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD042269L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01076304A) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2016-01-20 |