| NPI | 1184786519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD436090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT188720) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2011-12-05 |