| NPI | 1699982652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 045751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA md430334) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-12-01 |