| NPI | 1689085680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-01285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT206345) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2018-05-31 |