| NPI | 1457796559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017790) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015378) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2016-10-24 |