| NPI | 1972734903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS014198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT011175) |
| Enumeration Date | 2009-08-08 |
| Last Update Date | 2020-08-10 |