| NPI | 1952697674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD452457) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4307098992) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-04-17 |