| NPI | 1407116593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60772861) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD455283) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2022-08-29 |