| NPI | 1154546398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD436271) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT188353) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2019-10-24 |