| NPI | 1417987579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS008097L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA 05008097L) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-01-05 |