| NPI | 1922444017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OT015135) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102204727) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2017-03-16 |