| NPI | 1205036647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME130157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD441217) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2022-03-03 |