| NPI | 1649264169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0064928) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD420080) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2015-09-24 |