| NPI | 1225267966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS016856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012859) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2017-06-09 |