| NPI | 1245265354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2001-01560) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD452946) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-05-18 |