| NPI | 1588606669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 009511) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB07496700) |
| 207Q00000X Family Medicine (Licence: PA OS013106) | |
| 207Q00000X Family Medicine (Licence: DE C20007383) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2012-02-10 |