| NPI | 1467549865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2010024114) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT011902) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2016-12-22 |