| NPI | 1396088092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101261143) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203301) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2016-09-30 |