| NPI | 1124314059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT014335) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2016-02-04 |