| NPI | 1255352811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D73514) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD422957) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2012-12-06 |