| NPI | 1962419556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME 018391) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD420285) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-02-29 |