| NPI | 1295062461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS015745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012901) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2016-02-17 |