| NPI | 1528061983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD056517L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 48304) |
| 207Q00000X Family Medicine (Licence: NH 10892) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-07-29 |