| NPI | 1417268863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS015803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT013661) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2014-02-18 |