| NPI | 1710129747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MT196083) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A105654) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2011-04-26 |