| NPI | 1912218058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME116666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT198276) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2013-12-12 |