| NPI | 1699920504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS014893) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2014-01011) |
| 207Q00000X Family Medicine (Licence: NY 250633) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: IN 02003849A) | |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2016-12-05 |