| NPI | 1740342161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101244344) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT187597) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-01-28 |