| NPI | 1184003659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD467570) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208221) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2019-08-05 |