| NPI | 1659712362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 278774) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203579) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2019-05-24 |