| NPI | 1205041969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2008-00704) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT184979) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2016-11-22 |