| NPI | 1942207212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD436137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0005300) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2012-10-19 |