| NPI | 1174559173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME123730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD036252E) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2016-02-09 |