| NPI | 1295920650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0069518) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD432274) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2010-07-13 |