| NPI | 1376864694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD452068) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0010490) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2019-04-11 |