| NPI | 1700903879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 44240) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT188941) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2014-03-14 |