| NPI | 1811258122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD457813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT201293) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2016-08-17 |