| NPI | 1144626946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 25033) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016183) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2020-05-08 |