| NPI | 1164698122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD-445383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT189112) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2014-05-13 |