| NPI | 1528370806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD474812) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL32794) |
| 207Q00000X Family Medicine (Licence: WI 62583) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2022-03-09 |