| NPI | 1750602959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-00490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD441494) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2019-02-05 |