| NPI | 1962614552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000042560) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD429534) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2013-07-16 |