| NPI | 1760676548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD13039) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT187985) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2009-07-27 |