| NPI | 1720124878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD047524L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0064891) |
| 207Q00000X Family Medicine (Licence: DE C1-0008126) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2017-12-04 |