| NPI | 1467779819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 60897 - 21) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2019-09-12 |