| NPI | 1457374431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD445002) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101233487) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-13 |