| NPI | 1467890053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS017866) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015209) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2018-06-13 |