| NPI | 1548350382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-02119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS012949) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-05-06 |