| NPI | 1477817443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT 014786) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11082695-1204) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2019-08-06 |