| NPI | 1639433394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 280286) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202504) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2020-01-15 |