| NPI | 1376758748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 256224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012075) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT012075) | |
| 207Q00000X Family Medicine (Licence: PA OS014657) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2014-03-22 |