| NPI | 1316353600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0024048) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD462788) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2021-03-30 |