| NPI | 1346369782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102202911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS-005559L) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2011-10-26 |