| NPI | 1720211196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS016486) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO 2270) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2016-04-14 |