| NPI | 1972860427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0013198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD454480) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2019-07-03 |