| NPI | 1659699437 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 19210)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD448316)  | 
| 207Q00000X Family Medicine (Licence: DE C1-0011824)  | |
| Enumeration Date | 2010-05-04 | 
| Last Update Date | 2018-10-11 |