| NPI | 1871721456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS015497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012823) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2012-06-04 |