| NPI | 1316142748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 250181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT190821) |
| 207Q00000X Family Medicine (Licence: PA MD439713) | |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2021-01-28 |