| NPI | 1275559445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0061865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD062858L) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2009-05-14 |