| NPI | 1699060921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS016906) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT013922) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2016-10-05 |