| NPI | 1205156676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT013390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT013390) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2015-08-05 |