| NPI | 1003162959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO172301) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A12978) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-03-10 |