| NPI | 1336588748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101267258) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT205198) |
| 207Q00000X Family Medicine (Licence: IL 036.146908) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2022-08-24 |