| NPI | 1821227661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 250483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT194618) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2016-11-04 |