| NPI | 1417138140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD457627) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101243056) |
| Enumeration Date | 2007-11-22 |
| Last Update Date | 2016-08-15 |