NPI | 1629206693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD447191) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 270783) |
207QA0505X Family Medicine, Adult Medicine (Licence: PA MD447191) | |
Enumeration Date | 2009-06-29 |
Last Update Date | 2020-08-12 |