| NPI | 1811097041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 043497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD432289) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-12-10 |