| NPI | 1477711893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD450566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301100522) |
| 207Q00000X Family Medicine (Licence: VA 0101249844) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2015-10-02 |