| NPI | 1750381984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD449428) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 211874) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2014-07-30 |