| NPI | 1912959289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 11861) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD056289L) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-05-26 |