| NPI | 1871791244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60834465) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD444171) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2021-06-22 |