| NPI | 1134301781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME116359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT187191) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2013-08-12 |