| NPI | 1881708691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME111451) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD040841E) |
| 207Q00000X Family Medicine (Licence: NC 2010-00664) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2013-03-22 |