| NPI | 1558381012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS011005L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 102202230) |
| 207Q00000X Family Medicine (Licence: DE C20006590) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-08-19 |