| NPI | 1770858961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 72933) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2020-10-16 |