| NPI | 1336374255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0074019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT195174) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2012-08-10 |