| NPI | 1487759643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD446199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2008-0808) |
| 207Q00000X Family Medicine (Licence: MD D0075330) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-06-19 |