| NPI | 1912210568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 273107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT196664) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2017-12-11 |